Healthcare Provider Details

I. General information

NPI: 1285628875
Provider Name (Legal Business Name): MICHAEL S OBRIEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MICHAEL S OBRIEN MD

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 07/02/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 N HIGHLAND AVENUE
ARLINGTON HEIGHTS IL
60004
US

IV. Provider business mailing address

1430 N ARLINGTON HEIGHTS RD
ARLINGTON HEIGHTS IL
60004-4830
US

V. Phone/Fax

Practice location:
  • Phone: 847-287-7983
  • Fax:
Mailing address:
  • Phone: 847-253-3600
  • Fax: 847-253-3912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036095367
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036095367
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: